Does Highmark use eviCore?

Working with health care providers and care teams, we’re helping to implement nationally accepted, evidence-based guidelines. To that end, Highmark Delaware is partnering with eviCore healthcare (eviCore) for a new advanced imaging and cardiology services program, effective Jan. 1, 2019.

Does Highmark use NaviNet?

NaviNet is the preferred Highmark tool for inquiring about member information.

How do you do prior authorization on NaviNet?

Providers that are not able to submit requests for precertification/prior authorization through our online utilization management request tool on NaviNet may call our Prior Authorization team at 1-800-664-2583, Monday through Friday, between 8 a.m. and 5 p.m., Eastern Time.

What is eviCore phone number?

800-792-8744
Thank you for submitting. You will be contacted by an eviCore representative within 5 business days. If you do not hear back from us within 5 business days, please call 800-792-8744, option4.

Do you have to pay for NaviNet?

Providers can process and submit claims free of charge with health plans sponsoring NaviNet Claims, or choose to connect to 900+ payers nationwide for a monthly or yearly fee. NaviNet Claims is available 24/7 for claims submission.

How to fill out a Highmark prior authorization form?

A physician must fill in the form with the patient’s member information as well as all medical details related to the requested prescription. Once the form is complete, send it by fax or mail to the appropriate addresses below.

How to get Blue Cross Blue Shield pre certificatin?

To view the out-of-area general pre-certification/pre-authorization information, please enter the first three letters of the member’s identification number on the Blue Cross Blue Shield ID card, and click “GO”. If you experience difficulties or need additional information, please contact 1.800.676.BLUE.

Can you use Highmark if you do not have Navinet?

Providers who do not have NaviNet can use the HIPAA Health Services Review (278) electronic transactions for some types of authorizations. (If you are not NaviNet enabled, please contact your Provider Relations representative to learn about the benefits of conducting business electronically with Highmark.)

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Does Highmark use eviCore? Working with health care providers and care teams, we’re helping to implement nationally accepted, evidence-based guidelines. To that end, Highmark Delaware is partnering with eviCore healthcare (eviCore) for a new advanced imaging and cardiology services program, effective Jan. 1, 2019. Does Highmark use NaviNet? NaviNet is the preferred Highmark tool for…